I’m throwing in the towel but will continue working out as I LOVE it. I am going to eat sensible, keep up the weight training and see how it goes. I feel like I gave it a good run but if I haven’t seen results in 90 days I don’t feel this is the best way to eat for my body. I’m curious if anyone else has had lack luster results like mine while being diligent with a strick KETO diet.
The volumes of knowledge on display here make this book a mainstay in the field of ketogenic dieting.  This also makes it a really great option for anyone who’s interested in this high-fat diet. While this book is a superb document for anyone looking to enjoy the keto diet, don’t be scared as there is nothing too crazy in here! One of the best keto cookbooks for anyone just starting out and looking to learn the ropes.

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I give you points for not completely bashing the Keto diet but I have to ask you why do you think it is hard to follow? Do you tell vegans that their diet in unsustainable? I know for myself I can go to almost any restaurant and eat a keto meal the same could not be said with vegans. A properly balanced keto diet would require no vitamins or minerals (the reason for Keto “Flu”) the same can not be said for vegans, most vegans have major deficiencies and some vitamins like B12 are near impossible to obtain without supplements.
Once the medical community acknowledged the keto diet’s effectiveness in reducing seizure episodes, they decided to look further and study its impact on neurological diseases in general. Neurological diseases share a common problem – a deficiency in energy production. Ketones provide that energy for normal brain cell metabolism, and may even be a more efficient   when the body is in starvation mode. When patients were put on the keto diet, the number of mitochondria (energy powerhouse) in brain cells increased. Ketones may also act as an antioxidant by inhibiting the formation of reactive oxidant species, which is why they may have promising effects in the treatment of certain cancers in conjunction with chemotherapy.
DEXA (Dual-Energy X-Ray Absorptiometry): If you can afford it, a DEXA scan will give you the most accurate results. A DEXA is an X-ray treatment that measures body composition and can detect bone mineral density, lean body mass, and fat mass with great accuracy. However, they can only be done on a health facility and a comprehensive session can cost up to $160.

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No one is trying to diminish your success, but it does not work for everyone, and studies show it can have long term negative effects on your overall health. If you look at the Meta-analysis it shows a calorie restricted diet and Keto for 12 weeks had the same weight loss. There are also many studies that suggest looking back at people after one year those on a calorie restricted diet kept more of their weight off. The only one it does better than is just a low fat diet, which Dieticians stopped suggesting long ago. And as Health Care professionals we read the “REAL SCIENCE” not the internet articles, You Tube, Blog, book writers. One of the books written about it by Dr. Jason Fung. Have you looked him up on PUBMED? He has not written one article published in a real medical journal to be such an expert. It is not magic, it is not a cure. If you like the diet and it does not mess up your cholesterol then so be it but promoting it to others not knowing their medical history can be dangerous. What people don’t realize is that for year’s we have known that if you lose 7-10% of your own body weight your blood sugars will improve, cholesterol, and blood pressure. But you don’t have to do the fasting and put more burden on your Liver or potentially increase your risk for cardiac problems eating such high fat. If you do high fat at least do plant fats and not animal fats. But of course everyone is happy with your success but just keep a tab on your lab work.
The keto diet is amazing! I’ve been on it for 15 months now. I maintain 20 grams or less carbs a day. I lost 60 pounds in less than 3 months and have maintained that loss. My triglycerides and cholesterol numbers are far better than average. My blood pressure normalized within a month and I no longer take mesds. I have a heart condition called PVC and am off all meds for that as the symptoms are no longer a bother. Those symptoms, as well as blood glucose numbers, decreased considerably within 2 weeks. It is the most beneficial “diet” I’ve ever used. It is a lifestyle that I 100% support. It is sustainable long term. I go to the gym daily. I am now 50 and have better energy than ever and feel far better than I did in my 30s and 40s.

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With that in mind, I created a basic Keto Grocery List as a helpful resource. My goal is to make following a Keto Diet simple. It isn’t necessary to purchase every food item on this list. Consider it a helpful guide when you are at the grocery store. Instead of going out and buying all the foods on this list for the sake of stocking your pantry, I would suggest creating a keto meal plan first. Then, shop weekly for those foods that you need so that you build your keto pantry as needed.
Also, plan for modifications to the meals for other people in your home. You wonít be able to make totally different meals for yourself and your family for the long term. The best approach is to use the main meat dish for your meal for the entire family and then a carbohydrate side dish for your family. For example, if you are eating meatloaf you can add half a potato for the other members of your family.

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I started Keto 100 days ago after seeing numerous family members losing a lot of weight and inches. They are getting good blood results from their doctors too. I did some research before I started and found many pro’s and con’s but decided the pro’s out weighed the con’s as long as my medical team approves. I have lost 22lbs but more important I’m down many percentage points in body fat (17.35% total now) during this time and have just received the most amazing blood work results I’ve had in years, I’m 60 years old. I told my nurse practictioner and my cardiologist how I’m eating and my N.P. said she doesn’t know enough about it but wants to know all I could tell her and my cardiologist said different diets work for different people but keep doing what I’m doing, they both just want to keep monitoring my progress with blood work and followups. I really feel the best I’ve been in a long while. When I reach a body fat percetage I’m comfortable with I might boost my carbs up to 50grams per day and decrease the fats a bit. My cardiologist says I don’t care what you eat on Friday night but the rest of the week be very mindful of your diet and blood work never lies. I can live with that.

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However, from personal experience, I can say that the diet is not optimal for athletes (as this article points out). I personally lost strength on all of my lifts at the gym and felt light headed and weak when I tried to do any physical activity. That’s why I think that is good for couch surfers and desk jockeys that don’t work out and need to lose weight.
What really killed it for me was the unrealistic restrictions of the entire day carbs count you should end up with – there is no f***ing way I can get by one full day with 20 grams of carbs and under. Just one of my meals ended up with at least 15 grams of carbs (half small onion-small red bell pepper-half cup chopped mushrooms-cup green beans), sometimes 20-25, times 4-5 meals (amature bodybuilder) and I end up with ~100 grams of carbs per day, at least.

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A dirty keto diet also follows the standard keto diet but with disregard to the nutrient value or quality of the food consuming. For example, you could go to a fast food restaurant and order a bunless cheeseburger chased down with a diet soda and still be keto. This works if you’re traveling and really have no better options, but is not recommended in the long run because of a host of negative effects, such as the inflammation, cravings, increased blood pressure due to the high sodium, and bloating.

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Next up is The Ketogenic Cookbook by Jimmy Moore and Maria Emmerich. This is another great resource for anyone on a keto diet. It has over 200 recipes, beautiful photography, and features good, simple food. The large number of recipes will ensure that you will never be stumped when deciding what to make. The Ketogenic Cookbook is a near encyclopedia from some of the best writers in the world of ketogenic diets. They understand the need to offer legible, understandable meal options for those who may not be too familiar with the diet. This is why it is such a great resource for beginners to the keto diet.
Many versions of ketogenic diets exist, but all ban carb-rich foods. Some of these foods may be obvious: starches from both refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some that may not be so obvious are beans, legumes, and most fruits. Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Depending on your source of information, ketogenic food lists may vary and even conflict.

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Thank you SO much for your blog post. My niece went into Ketoacidosis recently and I compared it to what a former RN in my neighborhood has been doing & recommending to everyone (& they believe her because she used to be a nurse, but definitely NOT a Dietitian). Anyway, after reading, I learned they are completely different, however if a healthy person does test for ketones in their blood, what are acceptable levels? (This same nurse tests for ketone levels). I appreciate how much work you put into this write-up and honest feedback! (I work with 2 RDs who agree with you!)

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Slow cooking is also great for those who aren’t comfortable using a stove or an oven as slow cookers typically need minimal preparation and food is all prepared in one pot. This is also a great alternative to other books which typically rely on standard cooking infrastructure such as a stovetop. So, if you are a fan of the crockpot or simply looking to expand your ketogenic cooking repertoire, this is one of the best keto cookbooks you will find.

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But for evidence of the Keto Diet’s more immediate effects, Noakes brings up South African athlete Bruce Fordyce, 60, who won the country’s biggest ultramarathon, the 56-mile Comrades, a record nine times. He ate high-carb his whole life, eventually putting on weight and becoming insulin resistant. Recently, though, he switched to a high-fat diet—and has regained his former waistline and dramatically improved his marathon times. Little by little, according to Noakes, we’re learning. “This is the single most important health intervention we can make as doctors,” he says. “And as nations.”

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Dr. Jeff Volek performed a similar study in obese males that also looked at possible effects of resistance training in combination with the diet. In this study, Dr. Volek used a true ketogenic diet consisting of high fat and low carbohydrates. He found a comparable pattern and magnitude of change in body composition to the aforementioned study (6). He later performed another study including men and women. In this study (7) the participants were instructed to not change any physical activity behaviors and to continue with their daily lifestyle habits. The two diet intervention groups consisted of a very low carbohydrate, ketogenic diet (VLCD: 9%C: 63%F: 28%P) and a low-fat diet (58%C: 22%F: 20%P). The amount of calories that were restricted for both groups was based on the individuals’ resting metabolic rate (RMR). The women in the low-carbohydrate, ketogenic group responded much more favorably to the diet, especially in terms of trunk fat loss. Meanwhile, both men and women lost significantly more fat in the VLCD group than in the low- fat diet group. As expected, RMR decreased in both groups; however, the men in the VLCD group maintained a much higher RMR relative to their body mass than those the low-fat condition did. This has important practical applications, as most people who diet tend to have decreased metabolisms that make take a long time to recover back to baseline and in some cases may never fully return to normal.
Today makes 3 months since I started Keto and I have lost 43 lbs. The way it works for me is by using a meal logging App and sticking to it daily and trying to reach the macronutrient goal percentages as closely as possible. In addition, I have found that, for me, “unlimited amounts of protein and fat” does NOT work for me. I have to carefully restrict total daily calories and mix it “intermittent fasting” with lots of hydration to get the ketosis going. I also find that if I can eat low-carb high fiber greens like arugula, celery, non-peanut no-added-sugar seven-nut butter, walnuts, avocado and lots of water and soups, it helps me avoid constipation. I am feeling so much better without the weight, my sleep apnea is gone and edema in my legs is gone but I do have concerns about the saturated fat, my HDL/LDL and I do not like the “nail polish breath”. I have also read many articles on Keto and most are either “all in” or “no way” so I would like to thank you for the “balanced discussion” in this article. It must have taken lots of effort for a nutritionist to examine Keto in a balanced, objective style. Thanks again.
Thanks for the great article! As a fellow dietitian I think its challenging to stay on top of the fads and weight loss trends. The way I see it is that there are two types of ketogenic diets – lifestyle (for weight loss) and therapeutic for some of the medical conditions you mentioned above. Bottom line, the ketogenic diet is not a “natural” diet and there are serious associated side effects. I believe that people following the diet need to be supported by a team of medical professionals to ensure adequate monitoring.

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Abbey, I appreciate all the work you put into this but there are a few things you missed. Not all oils are keto friendly. Vegetable oils are a huge no-no which was not mentioned. Regular mayo usually contains soybean oil which should be avoided. You also missed that foods with preservatives are a no-no which excludes some cheeses (you said enjoy all the cheese you like). Processed sliced cheese or pre-shredded cheese in a bag at the grocery store contains preservatives. Ever notice how shredded cheese in a bag never sticks to itself but when you shred your own cheese it sticks? Preservatives. Most nuts are okay but peanuts are a legume and should be consumed in very small amounts or avoided altogether. Don’t go crazy either, nuts do have carbs. I don’t eat more than a half cup a day of salted almonds. That said, you could have mentioned that getting salted nuts is ideal as you do excrete more salt and other minerals in your urine (eating keto is diuretic so attention must be paid to salt, potassium, magnesium, etc. as you did mention) so finding simple ways to add salt and other minerals is helpful. I also take a multi-vitamin daily. You mentioned you cannot do high intensity workouts. You are not supposed to do high intensity workouts as elevating your heart rate too high actually stops the fat burning process in your body. Your heart rate should be 180 beats minus your age +/- 5 beats depending on fitness level. A 40 year old obese person shouldn’t go over 135 beats/min during a workout as that is the optimal fat burning window. Higher than that and your body reverts to storing fat reserves thinking it will run out if it keeps this pace. Which bring me to metabolism. Its been long believed a high metabolism is good. A high metabolism leads to more hunger (because you’re burning glucose faster), ingesting more food, and typically gaining more weight. Slowing your metabolism down AND teaching your body to consume slow burning ketones instead of quick burning glucose puts less stress on your liver mainly and on your body in general. There’s a lot more but this is getting long so I’ll finish with this. You said this diet focuses on quantity of food and not quality. This is confusing to me….wouldn’t organic and grass-fed meats, be of better quality than non-organic and grain fed meat? (they feed animals grains to fatten them up….shouldn’t that be a huge warning sign for us?). Is food without preservatives not better quality than food with preservatives? Aren’t beverages with no sugar or artificial sweeteners of better quality than sugar/artificial sweetener-filled beverages? I’ve never seen any keto advocate advise ignoring quality foods, in fact its quite the opposite.

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Wow..Keto is the hardest diet in the history of diets to follow. Lets just mention the fact you need to be a mathmatician to follow the macro…or is it micro…of eating 20 g…oh wait is it 50g of carbs…which is it? And what does 75 percent fat intake entail? Can i drink a cup of olive oil and thats a percent of fats for the day? And how many cal. A day are you allowed? Nowhere is that ever discussed.

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Hi. I have been on the keto diet for 6 weeks and have not lost any weight but even more concerning, my gerd is much worse. I’m taking ppi’s just to stay on the diet. Constipation which has always been an issue for me is now much worse, hello laxatives! For these reasons, I have decided to go back to a more balanced diet leaning towards vegetarian. Keto works for some, I’m not one of them. I appreciate your info.
The only way you can know how you respond to dairy is by slowly adding it to your meals. If you eat dairy and don’t notice any issues, you will probably be okay using dairy as a great source of fat. If however, you find that after eating yogurt or cheese you feel bloated, have cramps, get diarrhea or start vomiting, you will want to eliminate dairy until you figure out the cause. In some cases, people who were previously lactose intolerant have been able to add dairy into their diets after eliminating carbs, so you just never know. Food allergies are a tricky thing.

Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included. It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)—nutrients typically found in foods like whole grains that are restricted from the diet. Because whole food groups are excluded, assistance from a registered dietitian may be beneficial in creating a ketogenic diet that minimizes nutrient deficiencies.


While I do appreciate the amount of research that went into this article, I need to weigh in here— no pun intended. I am a 44 year old woman who suddenly and inexplicably gained a lot of weight at about age 20 and pretty much (albeit a few bouts of massive dieting and exercising) have remained fat until the age of 42. I had always been thin without having to give my lifestyle much thought before my sudden weight gain — so I have spent the last 20+ years becoming pretty proficient on learning how the body uses fuel. I have had success losing great amounts of weight a few times in my life — twice reducing my calories the “nutritional counseling” way — using the old school and outdated food pyramid and tons of exercise. It took literally having to spend hours and hours at the gym — being miserably hungry all the time — only to achieve slow progress at the scale. Months and months I would spent this way only to gain the weight right back the minute that I let go of the reins. I’m always hearing about “sustainable lifestyle changes” from you nutritionists— an I believe in daily exercise — but that lifestyle was completely unsustainable in the long term which is why so many people are unsuccessful.

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